Implementation of Red Blood Cell Transfusion Recommendations in the Pediatric Intensive Care Unit
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Implementation strategies to increase use of transfusion recommendations.
- Who it may be relevant to
- Registry conditions: Red Blood Cell Transfusions. Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Transfusion Recommendations Implemented in the PICU (TRIP)
Overview
Evidence demonstrates that the risks of red blood cell transfusions outweigh benefits in many patients who are hospitalized in the pediatric intensive care unit with increased risk of organ dysfunction, infection, delirium, and death. Recommendations have been developed to restrict transfusion in patients who are unlikely to benefit; however, these recommendations have not been consistently adopted into clinical practice. This study examines use of targeted efforts (implementation strategies) to improve implementation of the recommendations, with a goal of reducing unnecessary transfusions and improving patient outcomes in critically ill children.
Interventions
- Other Implementation strategies to increase use of transfusion recommendations
Five implementation strategies will be employed in this study to enhance use of the blood transfusion recommendations. These include 1) building consensus, 2) provider education, 3) identifying and empowering champions ,4) use of computerized clinical decision support tools, and 5) provide quantitative metric-based feedback. Strategies 1-3 will occur prior to initiation of CCDS tools. All patients admitted to the PICU following the date of CCDS tool initiation will be considered to be part of th
Primary outcome measures
- Mean change from baseline in transfusion recommendation adherence at 18 months (evidence-based threshold alert) [Time frame: 18 months]
Secondary outcome measures (2)
- Mean change from baseline in transfusion recommendation adherence at 18 months (transfusions that require clinical judgement) [Time frame: 18 months]
- Reach of computerized clinical decision support (CCDS) tools [Time frame: 18 months]
Eligibility criteria
Inclusion criteria
- Employed at Lucile Packard Children's Hospital at Stanford University or the Children's Hospital of Philadelphia AND
- Employed in one of the following roles:
- PICU nurse
- PICU attending
- PICU fellow
- PICU resident
- PICU advanced practice provider
- Other physician or surgeon in subspecialties whose patients regularly receive transfusions in the PICU
- PICU TRIP implementation team member
- PICU nursing leader
- PICU physician leader
- Bood bank leader.
Exclusion criteria
- Unwilling to participate
- Directly report to the primary investigator.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 2 centers
- Lucile Packard Children's Hospital, Stanford University — Palo Alto
- The Children's Hospital of Philadelphia — Philadelphia
Identifiers
NCT: NCT07108374 · 70193 · HS029298-03